Building Resilience 102

I feel lonely. Alone. But I won't always feel this way. And saying that doesn't change how scared and self-blaming I feel about my loneliness.

The emotions. I will keep re-living them until I can put them to rest, put names on their graves, and grieve.

I stared out the window. It wasn't a blur, passing us by: it was snapshots, taken at every heartbeat. Log. Vines. Sheep. Brick. The window was dirty, but we just had it cleaned. Snowdrop. Reflector. Rock. Cyclist. Rock.

"I suppose it will be like this." I held the sadness. "I will always have moments of grief, missing things, people and places I cannot have anymore." I saw her face. I thought of leaves whistling and the chill of a wet wind on my cheek. "And even then, I know nothing will bring those moments back."

They are nowhere. They are no more.

When you express yourself, you express yourself beautifully. Another curving smile. I only have the words that other people have given me. These emotions; those too. Wordless. You can do anything. 

I believe you.

2 puffs, twice a day

She smiled at me and asked how my moods were.

"You never would guess it, you know." She gestured at me. "Seeing you here, as you are now."

Duplicity. Her words tapped into the heart of me. I looked away, feeling deeply sad but smiling anyway. "Yes. Well." That's part of the problem. "It wouldn't be possible without the medication." 

She smiled earnestly, encouragingly, at me. I told her about my social anxiety. I promised to find a way to take my inhalers regularly. We said good bye. I walked out of the room, wanting to say: "It's you." You're the reason I smile. You're the reason I feel safe. 

I wish the world had more of you.

Building Resilience 101

I have a Very Important interview coming up soon, which could mean a big change in my career and lifestyle. Because of this, and many important deadlines at work, I've been ignoring this blog and ignoring the fact that, no, the psychiatrist has still not contacted me. Not the week she promised to, not even the same month. Were I not balanced and ready to jump into this Very Important opportunity, I would pursue this unreasonable delay.

But the reality is, it's not the right time to start medication. This month has been put to better use finding other ways to cope -- most especially, preparing for the Very Important interview.  I'm pleased to say I have been productive so far, and I've been recognising and coping with triggers for my anxiety. There are still far too many to make significant progress on my own, but I am moving forward.

Part of that moving forward means becoming more familiar with (rather than defending against) the deep shame I feel in response to the many years of bullying and neglect. It's woven into the most numb moments, as I slosh water everywhere, rushing through the bathroom, avoiding the mirrors, avoiding myself.

The answer is Slow. Slow everything down. Slow my breath. Slow the movement. Relax the muscle. Each one, one by one. Slow.

It takes time. Things take longer, far longer than ever before. And I realise, then, how I came to sacrifice so much of myself in the last 30 years, just to survive.

So, I'm changing the moments.

This morning I wrote "You are worth it" on the misty mirror. These affirmations would have never worked while my thoughts were so severed from my feelings. It's the right time now.

My phone buzzes -- the Track Your Happiness project is ready for my next survey. How do I feel on a scale of Bad to Good? For the last week, I wondered if the emptiness I felt was really all that empty. Could it be good? Could I really feel good?


These are exciting times, because, illness aside, this is the start we all need to form ourselves. This is what Psychotherapist Number 2 meant when she said just letting yourself feel what you feel, because it is feelings which form our understanding of who we are.

I want to name the feeling. I think I'm happy.

I'm still (very often) many other things. But for the first time, Good is more than fleeting. Good has taken root.

As expected following the integration of EP-Sad and EP-Happy, I feel the worst I've felt in years. Seriously ashamed, sometimes suicidal, but also good. A modest sort of good: like the first minute of relief from a migraine or in going outside after a major thunderstorm. Tired, wary, but relishing the newfound space to live.

We are approaching the anniversary of some pretty remarkable changes in my life. Reading old posts is scary and brings a different sort of shame, but mostly I feel like a little girl, jumping up and down, calling on everyone who ever loved her:

Are you proud of me? 

The Parent in me smiles, because she knows that what the Child really means is this:

I am proud of me. 

And the Adult sitting before you feels Good, because she believes, where she didn't before:

That pride is no longer yours to take.

How can I help you today?

At first she said she would call me tomorrow. No, actually -- "Sometime this week."

It's 5 pm on Friday and still no call. Maybe the team meeting was eventful. Maybe she is waiting on decisions made by other people. Maybe she forgot. Either way, it was out of my hands the moment I walked out of the clinic, so nothing has changed for me. (We are called patients after all...)

I would have rather had something to report. But in lieu of news, here is the formulation (of sorts) that I made for my New Patient appointment with the local psychiatry team registrar:

Eliza's self-made formulation of sorts

I hope that I get better at asking for help each time I meet with a new clinician, but in reality the reason I need help is because I'm not very good at explaining what is wrong. There's this Really Big gap in my brain where most kids learn how to be vulnerable with and trust in others... it covers things like how to translate that sicky stomachy feeling into "Mom, I'm scared" and how not to panic every time you desire something (or someone).

Talking to me and reading my blog now, it's easy to forget that not so long ago I nearly went psychotic trying to say I'm angry. 

I remember how it felt, in exquisite detail, to turn the feelings inside into words: shaping my mouth, pronouncing the sounds. I hope I will always remember the pain it took to create, for the first time, synapses and connections where there were none before. That level of terror is meant to disable us, but still I persevered. 

"Have you ever had medication?" She asked, her voice gentle and bright. 

I shook my head. 

The conversation continued. A few minutes later, we looked again at my timeline: multiple moves, a lifetime of depression and anxiety, dissociation, psychotic blips, and --

"You've really never had medication." Her expression was a mixture of disbelief and concern.

"Never." I watched her carefully. She looked at me a brief moment and then turned away. 

I think she expected me to protest. But instead I said that medication would give me some respite from the increasing anxiety and help me engage more in therapy. I asked how medication would help me, how I would know it was working, and how long I could expect to be on it. 

Now for the moment of protest. I gathered my defenses and met her eyes. "I don't think medication is the answer." It's not a long term solution. I faltered, filling with tears. "I need to improve my social skills or I will always be at risk." 

We both stared at my formulation. 

She agreed.

An unexpected eulogy

A friend broke up with me over text, which I suppose makes me 0 for 2.  And the typical borderline reaction was there, of course, as I sat burning in the sun and shame. Were I alone, maybe it would have grown, but instead, through the quiet broke the chirping voice of a coworker...

...Asking me about said friend, our mutual ex-colleague.

I paused. "That text was from her. Ex-colleague is happy and doing well."  I paused another long moment, observing my feelings. And then, in the closest to Emotional Ground Zero that I have ever been, I told my coworker the truth:  "She said she doesn't want to see me anymore." Something about the relationship being one of circumstance. And something more about how, on reflection, the intensity of it did her harm.

We both sat there in silence.

It was a hard day, even without this news. And it's easy to lose myself in the mess of emotions and memories that surface with this powerful trigger of rejection and loss. But I held onto the complexity of it, the pain and the longing. I still care about my friend. I believe her when she wishes me well. And I agree that our friendship was intense. I understand the desire to move on, and I respect her for establishing a boundary.

As usual, I am grateful for another precious opportunity to learn. For example, I now know how wishing someone well for the future means little when it follows a criticism of the past. A part of me (looking and sounding a lot like Psychotherapist Number 2, actually) did not hesitate to observe that a little appreciation would have made the loss a lot easier to bear. Will I remember, in the future, if I were ever in the same position?

I don't chase after the thoughts. I let the feelings sit.

I expect to feel sad for a while. But they don't consume me. I still feel other feelings. And soon enough, the feeling of rejection will fade. In less than a day, in fact, I have the perspective that I didn't experience this loss alone. My colleague was there. I shared it with her.

These details are easily missed; I suppose we take for granted the idea of shared experiences... that there will always be someone ready, available, and listening. I know that I am not as alone as I feel, and that a large proportion of that feeling (and that status) is down to me, living protectively in my own world, unable to see the presence and availability of others.

More and more, I abandon the glasses that got me this far. If I'm overwhelmed by an emotion, sometimes the answer is to start paying attention to a different emotion. In this case, gratitude.

I'm grateful to my friend. I wouldn't be where I was today without knowing her. I would have liked to continue to learn and grow, knowing her. I feel sad that I might have, in some way, contributed to her ill health. But mostly I accept that we both did, and continue to do, the best that we could and can. And I feel proud of that.

I feel proud of us both. And a bit sad to be sitting alone with this feeling, because it's a good one. So  join me. If you like!

One for the analysts

The fact that I didn't feel elated to be "simply depressed and anxious" isn't lost on me. I've progressed enough now in my self-directed therapy to separate my anger at the nurse's stigmatising generalisations from the precious lesson that some part of me wants to be very, very ill. Dead, even.

"You have to know yourself, don't you..."  Edna O'Shaugnessy smiled pleasantly around the table, letting the words settle. "...and we can never really know ourselves enough, I think." 

The nurse called me the opposite of attention-seeking, and I felt 13 again, undeserving of the truth. In our last moments, Psychotherapist Number One had laughed, saying most therapists wouldn't be able to handle me, that only she could handle me, and my mind still burns with this living memory.  It isn't just my parents, my bullies... 

There is something about me that brings this out in people.

There is something about me that can change it.

Me. Not a nurse, not a pill, not a therapist. And I'm sorry for anyone that has lost, even for a moment, their ability to see that.

My life will be very different when I learn how to be so authentic that I disagree when I want to disagree, rather than sit and leave silently. I would have boundaries, real palpable boundaries based on values of my choosing, that people could respond to and respect. Interactions would be less terrifying and more rewarding.

My actions would say -- You deserve the truth from me. You deserve to know me. -- rather than the punishing inavailability I currently operate from.

This is what our Couples Therapist enabled us to see, as she "held our relationship for us" these past few months. I had the idea in mind, but not the feeling, and now I am able to see in practice how it comes together and why it is so important to push back.

The world and the people in it are being shaped every day; that's just what we do. That's how we evolve personalities and identities. That's how we draw a line around our Selves.

Well, consider my line drawn. And all the better, because the pen is mine.

My first assessment with the psychiatric nurse

I was just assessed by a psychiatric nurse. Thanks to some research, I knew moderately what the assessment would cover. What I didn't know was how it would be covered. And I'm glad to say nothing I could have researched would have prepared me for this.

"This"  doesn't deserve to be written in a poetic way. Because it's not poetic. It's not art. It's not a script. It's an hour of my life: the interface between myself and a local psychiatric nurse.

My first impression was that she was stern and clinical. Her smile was hard-worn. Her presentation was pristine, well-cared-for, and almost too-cared-for. She was quite defensive. Protective, even, to the point where her words and behaviours, though scripted to reassure and elicit trust, lacked all empathy entirely.

And that's what I felt as I sat there. So I couldn't look at her. Not out of shame, but because I knew that she was the Gatekeeper and whether I liked it or not, she was right. I needed to trust her, even if she didn't deserve it.

I hope at least one person from mental health services is reading this and reflecting on that sentiment. She didn't deserve my trust.

And I didn't trust her.

Instead, I visualised my therapists, one and two. My GP. My husband. The teachers who were good to me. My colleagues. Myself. I looked at myself and talked to her. The questions were textbook. The asides were not.

I found myself playing the game "tell or not tell" with every answer. And for the most part I was authentic. I was vulnerable, honest, and, as she put it: "articulate and intelligent."

I cried and shook from anxiety throughout most of it, soothing myself by repetitively and systematically squeezing the end of each finger. Folding and unfolding my tissues. Rubbing down my arms and legs.

The result of this assessment?

I am simply depressed and anxious.

I am not autistic, because I have feelings. Because autistic people don't sit there and cry.

I am not borderline, because I am not attention-seeking. Because borderline people have victim complexes and are manipulative and self-harm.

My episodes of hallucinations were most likely psychotic depression. And, "they" can't help me unless I agree to take medication. Err, "consider" to take medication.

She was shocked to find out I wasn't on any. Suddenly, she leaned into me, with a curving, seductive smile. Her voice lowered, bright and husky, as she recommended this "fantastic drug" called Sertraline which works wonders.

My body became lifeless, as I fell further into my armour of terror and disbelief. Is this what peer pressure feels like? Does she even realise what she looks and sounds like?  My brain rattled with American anti-drug infomercials of the 1980s: I'm not a chicken; you're a turkey!


Just say no.

She leaned back, with a self-serving smile, as I nodded, passive and accepting. "You're clearly an intelligent girl."  Did my eyes narrow just then or was I still nodding complacently? I stared down at my hands.

There are so many things wrong with what she said, but what strikes me the most is how she said them: persuasively, as though I needed convincing. Her behaviour was unlike any therapist I ever met, because she's not a therapist. She's a psychiatric nurse. And I will try not to hold that against her, when I "consider" what medications the psychiatrist recommends at our meeting (yet unscheduled).

Wow.

I don't think she's wrong. I am chronically depressed and anxious, and I probably would benefit from medication.

I think, perhaps, that if I had received treatment for my depression and anxiety when the illnesses began (as a child), it would be that simple. But I'm 30 now, and medication cannot change the sometimes damaging, always complicated network of defences I've built up to cope.

So, I will see what the psychiatrist says, but moreover I will see how he says it. There is a world of difference between someone telling you that you need an anti-depressant and someone explaining how an anti-depressant will enable you to cope better with the daily stresses and engage in therapy.

This is absolutely a negotiation.

My body, my boundaries. A single pill will not become my only means of support in the world, and I refuse to be persuaded otherwise, especially when I am so vulnerable. I have much more powerful defences than a pill can provide, and if I need to use them, I will.

Like a true Narcissist, the nurse was surprised when I didn't express my delight at her gift of insight: I was not borderline or autistic. "Most people are happy about that." She shifted in her chair with a forced smile: her eyebrows furrowed, her eyes vigilantly observing me.

I felt ashamed. And, like the Narcissist I am terrified of being, immediately fought back with anger. I breathed. I soaked up my tears. I let her suspicious chuckles turn into silence.

And then I drew the line between us.

"Let me make one thing clear." I frowned at her like she was a naughty child. "I was isolated for most of my life." My eyes watered, my hands shook. "There is nothing that you could say that would soothe me. No label would change how I feel."

She withdrew from my boundary. The conversation lingered, and though I sat there, I was already gone. We stood. And then something remarkable happened.

I opened the door myself. I heard her say good bye. I left. I didn't look back.